We produced this resource in collaboration with the Care Inspectorate and other key partners to support those in inspection, scrutiny and improvement roles to recognise good practice in care and support for people with dementia, their families and carers, and work with a range of individuals and providers to promote effective change.
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Working with the SSSC
Heather - Over the last two years we have been working with the Scottish Social Services Council and staff within our own organisation to really develop a resource that would fit our needs, really looking within the Promoting Excellence framework to see where our Inspectors and staff need to be with regards to their skills and knowledge in relation to dementia care and support. If we are asking providers to provide a knowledgeable workforce, then we have to then do the same. Thinking around dementia and practice is constantly evolving and we have to be a part of that. Some people will look at the resource and be very familiar with the contents, it will be the case of maybe a refresher, looking over it , seeing where the gaps in their knowledge are, but it might be a really good opportunity to sit down with colleagues and have a bit of a discussion.
Our role in improvement
Heather - Within the Care Inspectorate, we have a role for improvement, which I know surprises some people, so as part of the inspection, the inspection will happen, people will go out, they will observe what is happening within a service, whether that is a care home or a day centre or housing support for example. From that really good evidence is gathered, evidence to support the really good practice that we see, but also areas for improvement. What we want to do within the Care Inspectorate is look at some of these areas of improvement and support providers to take them further, to really develop and I think what we are seeing again is a shift, a real shift towards quality of life, a meaningful life for people living with dementia.
Heather - Last year 2014, saw the Care Inspectorate introduce the Short Observational framework for Inspection (SOFI). This is a really useful tool because it is one of those tools that really aid us within our improvement role because it captures and highlights the experience of people living with dementia that maybe can't verbalise, maybe can't communicate effectively their experience of receiving services. We are able to capture that lived experience of living with dementia, to see how it can promote wellbeing, person centred care and really those quality of life indicators that are outlined within the Dementia Strategy.
Joe - One of the quite simplistic models that we use for regulatory theory is called direct, detect and effect. Lots of people think that the care inspectorate and Healthcare Improvement Scotland are all about inspection and we go out there and we do an inspection and we find things out. But fundamentally our job is a lot more than that. So for example one of the things that we are getting much better at doing is directing services to excellent practice, and good practice. And if we do this in a helpful, meaningful way, a lot of services will actually be proactive and will be doing these things. So that when we go out to inspect they will already understand what it is that we are expecting them to be doing. So direct is important, to direct services to resources and evidence based practice to help them improve. The Detect part of our work is very often associated with inspection and I've already talked about tools like SOFI that help us to detect things. But probably the most important thing for a regulator is the effect that we have. And the effect that we want to have is to improve care outcomes for people using services. For people that have dementia we want to improve the care that they receive. And that's the effect that we are having. And ultimately we can direct services and we can go out and do inspections, but if we are not enabling and helping and working with them we are not having the effect that we are want to have.
Using regulation to promote excellence in dementia practice
Joe - The principles of the Public Service Reform (Scotland) Act which brought about the Care Inspectorate and Healthcare Improvement Scotland require us to promote things like health and welfare, but also independence of people. Independence is an interesting principle. It's one that we all take for granted. But I think when you have dementia perhaps you feel less independent than you should. But inspectors have a duty to promote that independence. So when they are out inspecting there are some key things that they have to have. That's good understanding of how to regulate, and the theory of regulation supports that. But two other things that are really essential are good interpersonal skills, and that's not just about interacting with services but it's also how to interact with people in the services. Linked to that is a really good experience and expertise in what it is that they are regulating. So for example if you are an inspector, inspecting a care home for people who have dementia, then you need to have a really good understanding and ability to communicate with people...
This is what some inspectors had to say
Marie - Through Promoting Excellence and online learning, we can keep ourselves up to date but it's also important as well as doing online learning to meet as groups and discuss our understandings. And Promoting Excellence training with the DVDs, case studies etc is the way we can explore some of the theory about working with people with dementia but more importantly we can support services to move forward. And through us learning of some of the materials out there, of the resources out there, we can signpost services to best practice and help things improve in Scotland for people living with dementia.
Clive - When as an inspector you are out working with management staff in care services and observing staff practice, what we try to do is promote the Promoting Excellence regarding dementia care. It gives staff up to date information of how they should be providing care and gives them a whole host of resources that they can link into to ensure that their practice is as up to date as possible.
Susan - A lot of the work that I have done in inspection has been for older people, and that has been Care Home Services but also Care at Home Services, and Day Care Services too. For Promoting Excellence, one of my favourite things about it is that it is the Scottish Executive, or Scottish Government, who are setting out the standards that are there and it works alongside the dementia standards. And if clarifies for services what our expectations are; what staff should be doing, how people are best supported. I think a lot of the inspecting that has been done in the past has been around physical care needs, and they are important as well - Maslow's hierarchy is very useful. Physical care needs are important but equally important are the social and the wellbeing care, and certainly the older I get that brings into focus what good care is about and how as a regulator I need to look for how individuals are being supported through the staff and Promoting Excellence guides them.
Working in partnership to create your resource
We have been really fortunate within this resource to have the experiences of people living with dementia, hear the voice of people within the Scottish Dementia Working group and also the carers from National Dementia Carers Action Network, so the resource really captures that lived experience of what it means to live with and really care for people with dementia.
We have also had the opportunity to meet with many members of staff from across the Care Inspectorate, Health Improvement Scotland through the focus groups that we did, really capturing some of the key themes, some of the issues that you face in your everyday work.
I'm really looking forward to hearing how this resource is used. It can be used individually, it can be used on line, and you can come together as teams, which I think is very valuable to hear your peer discussions of some of the issues.
Sometimes there is no right or wrong answer, so having these discussions is really what is going to enhance your practice.
So please keep in touch with us, get back to us and I will be looking forward to hearing how you got on with it.
This resource has been designed for use in a blended format. Ideally you will be able to use this resource in self-directed study, whilst also having the opportunity to discuss learning and broaden your knowledge within informal or formal group environments - including team meetings and facilitated training sessions. Additional guidance on using this resource can be found in the using the resource tab. It is hoped that before using this resource you will have previously completed or aligned your existing learning to the Dementia Skilled: Improving Practice learning resource. Find this and other key background reading here.
This was printed from a website hosted by the Workforce Development and Planning Department at the Scottish Social Services Council.
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